枢

The atlanto-axial joint disorder is a idiopathy that the micro-transposition from atlanto-axial joint to atlanto-occipital joint and the injury , strain and anaplasia of the peripheral issue leads to stoke, diziness, vomiting,etc. The old people happen frequantly, eapecially the workers hung the head do.

寰枢关节紊乱是以寰枢关节为中心，以寰枢关节及寰枕关节的微小错位及其周围组织的损伤、劳损、退行性改变等病变所产生以头痛、眩晕、恶心为主症的特发性病症，多发生于中老年人，尤其以低头位工作者为多。

The front suture width of axis and atlas joints and the shift degree of dens were also measured.results: 13 cases with 19 bone broken points,the positions are at dens ,side plank of atlas,occipital,plank of axis,processus spinosus etc.23 cases with axis and atlas half dislocation.of which,16 cases were with pure dislocation,7 cases with rotating dislocation,11 cases were with swollen at the side of vertebra,2 cases with depressing of vertebral artery,5 cases with continued narrowing of vertebral canal.conclusions: ct has the advantage of quickness,safety and high density discerning,it can reveal details of acute axis and atlas damages,so it has great importance to treatment scheme making and to the prognosticate.

结果：13例共见19处骨折，部位分别为齿状突、寰椎侧块、枕骨、枢椎椎板、棘突等，寰枢关节脱位23例，其中单纯性脱位16例，旋转性半脱位7例，11例合并椎旁血肿，2例见椎动脉受压，5例继发性椎管狭窄。结论：ct具有快捷、安全、密度分辨率高等优点，可明确急性寰枢关节损伤细节，对制定治疗方案及估价预后具有重要作用。

Results In 7 cases of odontoid process fracture, X-ray demonstrated 4 cases and CT demonstrated 5 cases, whereas the spiral CT reconstruction diagnosed 7 cases, which could display the displacement of fracture clearly. The X-ray and CT showed asymmetric space between left and right gaps of atlantoaxial joint in 6 cases, while spiral CT reconstruction showed normal and excluded the possibility of atlantoaxial dislocation. There was one case of lateral atlantoaxial joint dislocation, which was demonstrated by the spiral CT reconstruction clearly but not by the X-ray and CT scan. There were 3 cases of atlantoaxial congenital deformity (1 case of absence of both posterior arch of atlas and odontoid process and 2 cases of maldevelopment of the odontoid process), which were displayed clearly by spiral CT reconstruction, but misdiagnosed as odontoid process fracture and atlantoaxial subluxation by X-ray and CT scan.

结果 7例齿状突骨折中，X线显示4例，CT显示5例，CT重建确诊7例，且清楚显示骨折移位情况；6例X线、CT显示寰枢椎左右间隙不对称，通过CT重建排除寰枢关节半脱位；寰枢外侧关节脱位1例，CT重建可清楚显示，而X线片和CT平扫均未能显示；寰枢椎畸形3例，分别为齿状突、后弓缺如1例，齿状突发育不良2例，CT重建均能清楚显示，而X线、CT均误诊为齿状突骨折、寰枢椎半脱位。

In such case, the Privy Council shall select a Privy Councilor to act as President of the Privy Council pro tempore.

在这种情况下，枢密院应选择一个枢密院委员担任主席的枢密院临时。

They permit the government to make law through the Privy Council, without the need to go through the full parliamentary process.

枢密令。枢密令允许政府通过枢密院制定法律，而不需要经过完整的议会立法流程。

Results: Under the two boundary conditions, finite element analysis results demonstrated that the ossification degree of the subdental synchondrosis did not obviously influence the high stress distributions, as well the maxium von Mises equivalent stress.

结果：两种约束条件下，枢椎有限元计算预测结果发现枢椎软骨基质的融合程度对枢椎高应力集中带分布无明显影响，最大von Mises等效应力值改变亦不明显。

［Objective］ To analyze the outcome of internal fixation for occipitalization with atlantoaxial joint dislocation by posterior decompression and occipitocervical fusion ［Method］ From December 2005 to June 2007,8 patients with occipitalization and atlantoaxial joint dislocation received removal of the posterior arcus of atlas and the enlargement of the posterior edge of the foramen magnum after skull traction performing for an average of 135 daysAll patients were operated on by posterior craniocervical fusion using cervifix internal fixation system and autologous ilium graftsThe clinical efficacy after operation was analyzed by Japanese Orthopaedic Associationneural function score ［Result］ All the patients were followed up from 6 months to 2 years, average of 15 monthsNo complication was foundAtlantodental interval was 5~9 mm before and 4~6 mm after skull tractionAtlantoaxial joint dislocation didn't completely reducedThe neurological defects were improved to some extents according to the JOA scoreImageology showed all patients had full decompression and bony fusionThe loosening or broken internal fixation was not found ［Conclusion］ Posterior decompression and fusion is a feasible method for the treatment of occipitalization with atlantoaxial joint dislocation,and the clinical effect is satisfactory

分析后路减压枕颈融合内固定术治疗合并寰枢关节脱位的寰椎枕骨化临床疗效。［方法］2005年12月至2007年6月间，对8例合并寰枢关节脱位的寰椎枕骨化患者在行颅骨牵引治疗一段时间（12~16 d，平均135 d）后采用枕骨大孔后缘扩大，寰椎后弓切除减压取自体髂骨枕颈融合Cervifix系统内固定术，手术后采用日本骨科学会神经功能评分分析临床疗效。［结果］8例患者随访6个月~2年，平均为15个月。8例患者无一例出现术后并发症，术前寰齿前间隙为5~9 mm，经颅骨牵引后为5~7 mm，寰枢关节脱位未能完全复位。手术前后JOA评分示神经症状均有不同程度恢复，影像学检查示枕颈区减压充分植骨区获得骨性融合，无一例出现内固定松动或断裂。［结论］合并寰枢关节脱位的寰椎枕骨化患者术前仔细评估影像学改变，采用颅骨牵引一段时间后行后路减压枕颈融合内固定术的治疗方案是合理可行的，且临床效果满意。

The traction arm includes: a first supporting plate slidably connected to a beam of the bench; a second supporting plate pivotally connected to the first plate for the rotation of the base about a first axis that is substantially horizontal and substantiallty at right angles to the front plane of the first plate for appllying the base to the repair bench; a third supporting plate pivotally connected to the second plate for the rotation of the base about a second axis that is substantially at right angles to the first axis; and pivoting elements for the rotation of the base about a third axis that is substantially at right angles to the second axis.

牵引杆包括：一可滑动地连接于修理台梁的第一支承板；一枢接于第一板、用于使底座绕一大体上水平且大体上垂直于将底座装在修理台的第一板的前平面的第一轴线而转动的第二支承板；一枢接于第二板、用于使底座能绕一大体上垂直于第一轴线的第二轴线转动的第三支承板；以及用于使底座能绕一大体上垂直于第二轴线的第三轴线转动的枢接件。

The odontoid vertebra space in the model was divided into lattices and the stress area of the odontoid vertebra was identified by force loading and analyses. It was found that the structure of the stress concentration area was closely related to the development of split sections. Therefore,when the odontoid process is attacked by the external force along its vertical plane,its waist is likely to break and type II fracture occurs. And the break also possibly appears in its base,in this way,type HI fracture occurs.

确定其材料性质、单元类型并控制好网格划分精度后，通过力的加载与分析，找出枢椎的结构应力区，根据结构的应力集中区与其断裂时断裂面走向的密切关系，从而判断出当外部载荷沿齿突中性矢状面不同角度作用，即齿突受到来自其矢状面的外部冲击时，容易在齿突腰部发生断裂，形成枢椎齿突Ⅱ型骨折，也可能在基底部发生断裂，形成枢椎齿突Ⅲ型骨折。

From the simulations, we can see the distributions and transmission of strain and stress in model under different loadings, and the results explained the fractures very well. 4. Similarly, a axis FEM model was constructed to simulate the axis fracture, emphasized on the odontoid process. Three kind of odontoid process fracture were analysed on this model, which occurred respectively on the tip, the middle and the fundus. The results gave the best angle to fracture the odontoid process of the axis.

四、建立了枢椎的三维有限元模型，对枢椎齿状突骨折机理进行了理论上的研究，重点针对临床上齿突骨折的三种分类：1、齿突尖骨折；2、齿突腰部骨折；3、齿突基底部骨折，赋予齿状突在矢状面沿各种角度下受力条件，模拟衰椎前弓、襄椎横韧带以及CZ－3棘间韧带对枢椎造成的暴力破坏，确定了最可能引起齿状突暴力骨折的受力角度。

Do you know, i need you to come back

你知道吗，我需要你回来

Yang yinshu、Wang xiangsheng、Li decang,The first discovery of haemaphysalis conicinna.

1〕 杨银书，王祥生，李德昌。安徽省首次发现嗜群血蜱。